RASH DECISIONSETHAN PETTIT, D.O. FAAP

ERYTHEMA TOXICUM

Up to 60% of Term infants

Healthy infants

Vesicles/pustues with ring of red around

E=E

• Erythema toxicum=Eosinophils

Typically gone by 7 days

PUSTULAR MELANOSIS

NEONATAL HSV?

INFANT NEVUS

Dilated fetal capillaries

• 40% of newborns

Flat, dull, pink

Front and back

• 95% of front will fade• 50% of back will fade

PORT WINE STAIN

NEVUS FLAMMEUS

Caution to Face distribution

Laser treatment

HEMANGIOMAS

HEMANGIOMAS

Benign Proliferation of endothelial cells.

1-3% at birth

10% Caucasians by 1 year

More females than males

More common in preterm or SGA

HEMANGIOMAS

Proliferation

• Up to year

Stabalization

Involution

• Typically after 2

HEMANGIOMAS TREATMENT

Location

• Cosmetic vs Dangerous

Large

Ulcerated

ECZEMAATOPIC DERMATITIS

TINEA VS ECZEMA

ECZEMA TREATMENT

Moisture, Moisture, Moisture

• Eucerin, Aquaphor, Cedophil, Aveeno, Vanicream• RIGHT out of the bath

Wet to dry wraps

ECZEMA TREATMENT

Steroids

• Creams:• Hydrocortisone 1%, 2.5%• Triamcinolone• Desonide

• Sometimes oral steroids

ECZEMA TREATMENT

Secondary infections

Cut nails short

Bleach water baths (1/2 cup per tub)

ECZEMA HERPETICUM

ECZEMA HERPETICUM TREATMENT

Treat the HSV,

Watch for bacterial infection as well

SEBORRHEA

Cradle cap

Scaly

Greasy

Usually not itchy

SEBORRHEA TREATMENT

Dandruff shampoo

Antifungal cream

Low potency steroid cream

KERATOSIS PILARIS

HIVES

HIVES TREATMENT

Steroids can help in extreme cases

Antihistamines

• Benadryl• Zyrtec• Hydroxizine

CHRONIC HIVES

May or may not have an identifiable trigger

Allergy testing

Most resolve within a few years

PITYRIASIS ALBA

PITYRIASIS ALBA

Often starts with erythematous lesions

Leaves behind hypopigmented lesions

Limited treatment options

• If topical steroids used with initial lesions, may prevent hypopigmented

• UV sun protection

PITYRIASIS ROSEA

Benign

Self limited

• Sometimes 6-8 weeks

Herald Patch

Christmas Tree pattern

INFECTION RASHES

IMPETIGO

IMPETIGO

Staph and Strep

Typically honey crusted

Often the face

IMPETIGO TREATMENT

Topical

• Mupirocen• Don’t forget the nose

Topical not enough

• Cephalexin

Sometimes MRSA

HERPES SIMPLEX

SCARLET FEVER

VIRAL EXANTHEM

SSSS

STAPH SCALDED SKIN SYNDROME

Toxin mediated

Tender skin

Shearing skin

Lack of mucosal involvement

compared to SJS or TEN (deeper)

MENINGOCOCCEMIA

HENOCH SCHONLEIN PURPURA

Tinea CorporisVs

Granuloma Annulare

KOH

TINEA VERSICOLOR

TINEA VERSICOLOR

KOH (spaghetti and meatballs)

Treatment

Selenium Sulfide

Topical antifungal

ACNE

Gentle Cleanser

Benzoyl Peroxide

Epiduo

Topical Retinoids

Retin A

may take 6-8 weeks

BUG BITES

SCABIES

SCABIES TREATMENT

5% Permethrin

Bedding cleaned in AM

Treat all family members (even if not symptomatic)

BED BUGS

FLEAS

STINGS

LOCAL REACTION

WARTS

WART TREATMENT

Cryotherapy

care to nail beds

Salicylic Acid

Tape

Abrasion

CALLUS

MOLLUSCUM

NEUROCUTANEOUS

NEUROFIBROMATOSIS TYPE 1

Café au lait macules

6 or more

Neurofibromas

often not until after puberty

Lisch nodules

CAFÉ AU LAIT

NEUROFIBROMAS

LISCH NODULES

TUBEROUS SCLEROSIS

TS ANGIOFIBROMAS

ACKNOWLEDGMENTSKelly McClean MD, Michigan Board Review

Robert Colman MD, Whitney Molis MD, Pediatric and Adult allergy P.C.

http://www.onlinedermclinic.com

http://hardinmd.lib.uiowa.edu/pictures22/dermnet/

http://www.skinsight.com/images

http://dermatlas.com

http://dermnet.com

http://dermatologyoutlines.com

http://www.allergyasthmamichigan.com

http://0.tqn.com/w/experts/Dermatology

Google images